Monday, August 01, 2011

Are Print Medical Journals Dead?

This morning in the Chicago Tribune's business section appeared an article entitled "Just What the Doctor Ordered" that included an interview with Dr. Howard Bauchner, the new editor for the Journal of the American Medical Association (JAMA). He plans to pursue a strategy of "intelligent innovation" for the journal:

...looking for ways to get information to doctors and consumers through several new platforms, such as social media, video and other forms. "If you look at TED or Big Think, they have been experimenting with video clips," Bauchner said. "I could imagine having some of our authors do video clips where they speak about the meaning of their research for eight or 10 minutes, and then that's easily linked to a smart phone."

He also wants shorter on-line version of articles that condense the topic to 500 words from the typical 2,500- to 3,0000-word articles not too dissimilar, I suppose, to the abstract.

Which leads to the inevitable end result: print medical journals are on life support. Like Borders Book Stores, print journals will no longer be archived in neat little rows in doctor's offices any longer - it simply is not how we get our information anymore. Dr. Bauchner, to his credit, acknowledges this.

But what he also fails to acknowledge is the business model that must keep pace with today's internet. Doctors have a myriad of choices as to where they can turn to get their information and unless the content itself is really compelling there will be too many other sources of feel-good information-crack out there that will catch doctors' eyes. Doctors will not pay for their content since there is no precedent to doing so, so the journal will have to rely on advertising revenue to fund their publications, much like the rest of the internet. Doctors and the public have already grown weary of the endless public relations "research" forwarded to our smartphones and the JAMA content will become just one more such source to cast a wary eye. How they manage to remove themselves from industry bias of "free content" provided to doctors will be JAMA's greatest hurdle.

But there's one other important challenge the journal will encounter in keeping their physician readers: their name. It will be next to impossible for the Journal to escape that fact that they are associated with the American Medical Association, since the odds of a rebranding of the name after 128 years is unlikely. Ultimately, how the next few years shape up for doctors might have more impact on the journal's physician readership than the content they deliver.

7 comments:

A troubling viewpoint: If doctors simply "read" journals or abstracts and don't critique/ponder/think about the details of the methods and studies' limitations, they'll be like robots, or simple algorithm-followers.

Interesting discussion, which has been going on in the STM world for almost 20 years. Indeed, I was at a professional society meeting in the late 1990s in which a Pitt research predicted print medical journals would be dead in five years. Ah well. But to me, the issue is no longer whether print journals will survive -- it's whether the print mindset in scholarly publishing will survive. Medical journals must truly evolve to better meet clinicians' fast-changing needs. Short videos of researchers explaining their papers will be nice but are hardly state of the art. The question is what journals can do to encourage and promote a new "unit of currency" in scholarly publishing that has all of the validity of a traditional paper but more utility and real-world impact.

It would be nice if doctors had time to review every article just like a peer reviewer would, as Dr. Schattner suggests. It would be wonderful if our individual opinion of what the research meant actually had any value in today's health care environment. The current reimbursement situation dictates that we do more work for the same or less compensation, so time is more at a premium. To complicate matters, the validity of information in peer reviewed journal is more suspect in recent years. Even when the information is scholarly and honest, does it have relevance to a physician's individual practice situation? We know that "scientists" can be vulnerable to promoting a political cause rather than science, e.g., the global warming cult. Under Medicare, bureaucratic dictates from a "panel of experts" may contravene the standard of care promoted in the literature. What, then?The AMA has evolved into a publishing company and political activist organization, promoting more government involvement in medical care, instead of being an advocate for its members. Perhaps that's why a small minority of physicians are members. As Bill says, that taints the JAMA. It also taints doctors who are not members!Some say we need more information to digest. Some say we just need a summary. Some say we need a video! IMHO, what physicians need is uncommercialized, unpoliticized, ungovernmentalized, accurate information, and be able to adapt it to an individual patient in order to provide them good specific care for their particular needs. Just get to me in digital format (CD or online) to save space and paper (be green?) and create better access. Spare me the propaganda lecture!

The last point is the most salient. No matter the format, they need a reputation, and the AMA is quickly squandering it's reputation such that no format could either help or harm it. They have already done the damage.

"... zombified mouthpieces for a self-serving and bloated academic establishment that feeds on taxpayer money and is on the brink of intellectual bankruptcy."Ooooh!! I bet that will leave a mark! Is the medical academic establishment as full of socialists as the rest of higher education?

About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.